Provider Demographics
NPI:1447374764
Name:SANDERS, LAKEISHA (OTR)
Entity type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13311 SW 17TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3417
Mailing Address - Country:US
Mailing Address - Phone:954-433-9865
Mailing Address - Fax:954-433-9964
Practice Address - Street 1:7650 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2967
Practice Address - Country:US
Practice Address - Phone:954-726-1415
Practice Address - Fax:954-726-1415
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10887225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist